**Additional Updated July 6, 2011 (Corrected Web Address) - Fiscal Year (FY) 2012 IPPS Proposed Rule Wage Index and Outmigration Adjustment Corrections (For Immediate Attention)
The Centers for Medicare & Medicaid Services (CMS) has become aware that an error was made in the calculation of the wage index outmigration adjustment in Table 4J of the FY 2012 IPPS-LTCH PPS proposed rule (CMS-1518-P), posted on the CMS Web site at: http://www.cms.gov/AcuteInpatientPPS/IPPS2012/list.asp#TopOfPage. The correction of this error results in an additional 104 providers being eligible for the outmigration adjustment in the FY 2012 proposed wage index. For a provider that is newly eligible for the adjustment and is not reclassified in the proposed wage index (under sections 1886(d)(8) or (d)(10) of the Social Security Act (the Act)), the correction to the outmigration adjustment also changes the provider's FY2012 wage index value listed on Table 2.
Since these changes could affect hospitals' geographic reclassification decisions for FY 2012, we are providing immediate notification of the corrections to Tables 2 and 4J of the FY 2012 IPPS/LTCH PPS proposed rule and a brief extension of the 45-day deadline of §412.273 (referenced at 75 FR 25881) for hospitals to terminate or withdraw 1886(d)(10) reclassifications as well as the 45-day deadline (referenced at 75 FR 25887) for a hospital to receive the out-migration adjustment rather than their section 1886(d)(8)(B) redesignation. A discussion of the corrections will be included in a Correction Notice to the FY 2012 IPPS/LTCH proposed rule (CMS-1518-CN2), which will be on display in the Federal Register sometime during the week of July 4, 2011. The corrections to Tables 2 and 4J are posted on CMS's Web site at: http://www.cms.hhs.gov/AcuteInpatientPPS/01_overview.asp. Hospitals that wish to request (or to revise a previous request) to terminate or withdraw an 1886(d)(10) reclassification, or to receive the out-migration adjustment rather than their section 1886(d)(8)(B) redesignation, must submit their request by no later than 7-days from the actual date of display of the Federal Register Correction Notice.
A detailed instructional letter (TDL-11384, 6-28-11, ATTACHMENT) has also been distributed to (or posted for) hospitals through their Medicare contractors and is available on CMS's Web site, also at: http://www.cms.gov/AcuteInpatientPPS/01_overview.asp, in the "Downloads" section. For questions, contact Brian Slater (410-786-5229) or Valerie Miller (410-786-4535).
**Updated May 25, 2011- The next Rural Health Open Door Forum is scheduled for Tuesday, July12, 2011 from 2:00pm-3:00pmET. If you wish to participate, dial 1-800-837-1935 Conference ID 59683815. This call will be Conference Call Only. Please see the Downloads section below for the full participation announcement. Thank you for your continued interest in the CMS Open Door Forums.
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Rural Health Open Door Forum Overview
The Rural Health ODF addresses Rural Health Clinic (RHC), Critical Access Hospital (CAH) and Federally Qualified Health Center (FQHC) issues, as well as some inclusion of other questions and concerns that occur in clinical practice pertaining to other CMS payment systems that also extend into these settings. Topics that frequently arise on this forum often deal with payment & billing for services subject to Health Professional Shortage Area (HPSA) and/or Physician Shortage Area (PSA) status, cost report clarifications, classifications for & qualifications of rural provider types, and the many special provisions being implemented for improving rural health in the Medicare Modernization Act of 2003. Timely announcements and clarifications regarding important rulemaking, quality program initiatives, and other related areas are also included in the Forums.
Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.
To learn more about Atlantic Financial Consulting you may visit their website at
http://atlanticfinancial.us or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.
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